Abstract

The Global Burden of Disease Study (GBD) was institutionalized by the World Health Organization (WHO) in 1998 to estimate the causes of death and disability worldwide for hundred of diseases. The WHO collected and analysed large numbers of data from epidemiological and clinical studies, for the majority of developing and developed countries. In 2019 there were 55.4 million deaths globally, 50% were people who were 70 years or older. The leading causes of disability and mortality were high blood pressure, tobacco smoking, diabetes, lack of physical activity and obesity.  Also, the GBD collected data for the leading global risks as measured in disability-adjusted life years (DALYs): Underweight (6% of global DALYs), Unsafe sex (5%), Alcohol use (5%), and Unsafe water, sanitation andhygiene (4%). Leading causes were: Cardiovascular, ischemic heart disease and stroke around 50%, Cancer 17%, Chronic Obstructive Pulmonary Diseases (COPD) 7%.  But also studies established that exposure to ambient and indoor air pollution is a major risk factor for global morbidity and mortality. Researchers estimated that more than 7 million people died prematurely from air pollution. According to the WHO, ambient air pollution (outdoor) accounted for 3.7 million deaths in 2012, most of them in low- and middle-income countries. Household indoor air pollution (cooking and heating) accounted for 4.3 million premature deaths. The total number of estimated deaths from air pollution is 7-8 million. This represents the shortening of global life expectancy by almost 3 years, on average. By comparison, smoking tobacco caused around 7.2 million deaths and is projected to increase to 8.3 million by 2030. The greatest effect that air pollution had on health was related to cardiovascular diseases (43% of global deaths). In terms of age, 75% of the deaths occurred in people over the age of 60. By region, the largest burden of disease related to air pollution is found in South-East Asia (India, China), reflecting heavy industry and air pollution hotspots. The rates of Disability Adjusted Life Years (DALYs) from air pollution increased in South-East Asia, and in Eastern Mediterranean regions where populations are both growing and ageing.

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